This forum is for questions about medical issues and research aspects of Hepatitis C such as, questions about being newly diagnosed, questions about current treatments, information and participation in discussions about research studies and clinical trials related to Hepatitis. If you would like to communicate with other people who have been touched by Hepatitis, please visit our new Hepatitis Social/Living with Hepatitis forum

High testosterone linked to men&#x27;s lower death risk/HR

http://www.reuters.com/article/healthNews/idUSN2640417920071126

Maybe HR can comment on the study. One question I have -- is it true that once you start testosterone therapy you have to continue it for life, as the body will stop producing its own? That's what I've heard and is the main reason I haven't tried it, now that it's dropped slightly below normal since I treated.

i also would like to hear about this. does the HCV alone lower testosterone? as you know i have not treated yet and my testosterone level is low, slightly above the lowest normal. the level has continued to drop since i first had it checked 2 yrs ago. i'm sure next test it will be below normal. add this to the other metabolic syndrom (syndrome) things and i'm screwed! sometimes i feel what is the use of treating the HCV because i have so many other negative factors. i just wish i knew if getting rid of the HCV would improve some of these things, i.e. BP(boarderline high),lipids(high total & tris, low HDL),testerone(low),glucose(boarderline). i have avoided taking a statin up to this point. i was taking a low dose of BP meds but stopped after exercising & diet brought it down close to normal. i do not want to end up like my dad (rest his soul) taking 10 different meds a day. talk about hitting 50 and going down hill! i'm the perferct example of this.......

I can only speak for myself, but I had high-normal testosterone prior to treatment, but now as an SVR my testotserone is below normal. My bp and lipid profile is also worse since treating with interferon. My doc said that tx can worsen the metabolic syndrome which it did. My feeling/understanding is that in some of us, interferon kind of wakes/speeds up conditions that we may have had prior, but were lurking/inactive -- and indeed that may never have surfaced, or at least to the extent they did. It's not uncommon to read people feel physically and mentally aged from treatment. Of course, some people report feeling great. You've read the threads and probably seen the survey. Where any individual will end up after treatment is impossible to tell.

forsee..you got the stones,no doubt..after the last discussion on this,i had my testo tested-fine thank-you and i'm w/ gauf on the indications!...but i whole-hearted concur on the after effects of trx - that formerly minor disabilitys become much bigger issues,mental&physical...other than that,i rejoice with SVR

The age related or disease/inflammation/etc related decline in the production of sex hormones by the peripheral glands is caused by a combination of molecular damage to the macromolelcular machinery/signaling /synthesizing pathways both in the hypothalamus/hypophysal axis as well as in the peripheral glands itself.

If a man (without any replacement therapy) is located in the highest 25% (quartile) of testosterone levels, it means most likely that his body/organs overall have suffered less degenerative/inflammatory/oxidative damage compared with his overall age group. This will certainly translate in a lesser incidence of health problems, way beyond a lesser drop in testosterone.

Thus testosterone here is mainly a marker of general health, less that the cause of the better general health.

This does not mean, that there is no benefit to the overall vitality, organ performancne ( beyond sexual activitires!) due to the higher levels of this vitral steroid hormone. But the degree of this contribution is not easy to gauge. There are many pos and some neg effects to high testosterone.

If Testosterone itself would be the major cause of the correlated good health as observed, then Testosterone replacement therapy would indeed serve to provide similar benefits as this corrrelative study , investigating "naturally high testosterone levels, showsl

But the studies on the use of testosterone replacement therapy in men deficient for it do not show a clear benefit pattern, - some benefits are regularly observed, of course- but the critically important benefit on the cardiovascular status is not clear from a review of the studies performed to date.

This is in contrast to the clear correlation of spontaneously higher levels of testosterone with health parameters as this study demonstratges. I repeat - correlation - only partly cause, for the reasons stressed above.

To Jims question:
The feedback inhibition of externally applied/internally produced testosterone on the production of LH and FSH ( the "gonadotrope hormones" of the hypothalmus/hypophysis)

will lead to a lack of such gonadotropins ( and hence peripheral testosterone production in response to those) for a while, once the external source is stopped.

But the finer understanding of the mechanisms of that feedback allows to circumvent this feedback inhibition to a good degree:

It is the production of estrogens from testosterone, by the aromatase enzyme, that is the operative basis for that feedback.

Therefore, inhibition of the transformation of the exogenous testosterone into estrogens by inhibition of aromatase is one way to counteract this effect.

Thre are several highly effective prescription "aromatase inhibitors" and also some natural substances ( some polyphenols) that also inhibit this conversion by aromatase, with a much lesser efficacy and these effects are not well researched in human studies, due to the lack of financial incentive for the performer.

Understood. But since the overall benefits of testosterone therapy aren't clear for the group, a reasonable approach for someone with low testosterone -- especially what appears to be interferon-induced low testosterone -- might be to try supplemental testosterone for "x" months and then try and draw some conclusions. The question then becomes what is the downside of such an experiment?

One downside I've heard is that the body might stop making testosterone at the same levels once therapy is started. This then would result in having to stay on testosterone therapy for life. I haven't really been able to confirm this with too many independent sources, so would welcome your opinion.

In short, if someone like myself starts testosterone therapy and then decides to stop -because of either negative sfx or no noticeable benefit -- will I end up worse off than when I began.

Our last two posts crossed, so my response (above) was not to your last post.

But re your last post, are you then saying that they don't know if its OK to go on and off testosterone therapy? I would like to try the experiment, but not if it means that if I stop taking it I will be worse off than before.

If you come off testosterone therapy, without the use of concomitant means to conteract the feedback inhibition, you will be lower for a while, compared with where you were before starting therapy. How fast you can snap back to previous at least low levels is a good question, I need to find a study that examined exactly that aspect. Cetainly it would not be for life, it might only be a few days.

It is also important to keep in mind, why these hypothalamic releasing hormones are produced and located in the brain. The brain determines/has an influence on the setpoint for the feedback regulation based on signals that it perceives to fit the need for the production of such hormones. Thus a beautiful woman, emanating strong pheromones will increase the perceived need, as will a sexually fulfilling intense relationship.
The often castigated "need "; for some men to have a "second youth relationship" is possibly a reflection of such a recharged hypothalamic setpoint, with health benefits perceived/received beyond the immediate, obvious pluses and in spite of the often detrimental sociological consequences of such behaviour. In these situations peripheral testosterone levels will rise naturally. Goethes Frau "von Stein" was probably one historically known example of such delicately achieved health benefit...

thanks HR & jim. HR can you please answer the question i asked in my other post in this thread, can the HCV by itself cause the low testosterone? i have read that liver disease will cause the testicles to shrink, could that be related to low testosterone? is it possible that treating HCV can be beneficial with some of my health problems i have posted above? i really find it hard to believe that most of my health problems are NOT from the HCV. there has to be a link between them & HCV. eventually they will find the connection with all the extra hepatic manafiestations. like they say the liver does 500 functions in the human body so it only makes sense that metabolic & other things are related somehow. just my opinion of course.

HR: Thus a beautiful woman, emanating strong pheromones will increase the perceived need, as will a sexually fulfilling intense relationship.
------------------------
Possibly, then I should re-think supplemental testosterone therapy as the stimulating mechanism. Perhaps instead, you could write me an rx, for one of those instead.

I don't have the answer, but in my case the low testosterone appeared only after SVR. I therefore came to the conclusion that it was interferon-induced. However, HR has got me thinking that maybe I need to inject something else other than a drug. And all this time, I thought Jenna was adequate.

Many hormones, and other signaling molecules, are processed/modified in normal liver functioning on top of the better known influence on nutrient/small molecule metabolism. Bu the negative effects of HCV infection extend well beyond a diminishment of liver functionality.

There is a bodywide increase in inflammatory signaling/inflammation, with numerous detrimental consequences,

firstly simply because there is an "inflammatory focus" namely the liver with all the foreign antigens and the resulting immune attack, that sends activating signals out to every other not directly involved bodywide component of the immune system.

Secondly there is the "Trillion a day virions" destruction and peripheral reticuloendothelial system processing of the resulting viral antigenic debris, that will carry and spread the inflammation bodywide.

Thirdly, there are numerous neutralization ineffective yet readily produced immune complexes floating around in the peripheral circulation, ready to be trapped anywhere in the capillary bed of peripheral organs , with the potential consequence of initiating a complement activation right on site - instigating yet another proinflammatory chain reaction.

Nevertheless, the metabolic syndrome itself can and often is the cause for multiple endocrine functioning deficits, without any HCV infection, mainly because of the proinflammatory stimulus that is generated/originates in the abdominal fat and the negative consequence of the insulin resistance that hampers the functioning of peripheral tissues in itself eg the production of sex hormones. Obese men have lower testosterone levels, there is no doubt about that, furthermore obesity tends to lessen the positive feedback to be had from sexually stimulating relationships as mentioned above.

In a particular case one could only guess as to the relative contribution of HCV disease and the metabolic syndrome/lifestyle disease to an observed low level of endocrine functioning.

sorry i meant to put HR in the 'to" box. yes count me in on one of those "rx" beauties"! i was thinking, perhaps you could "take one for the team" and try the testosterone replacement therapy and let me know how you make out so then maybe i will try it. come on jim do it for all of us low drivin men out here, we are counting on you.... :-)

this stuff is all interesting...lots of it over my head.... i'm kind of in the same boat as you...for the last 8 years i've had a lot of things going on..for 6 of them i didn't even know i had hep c...after reading loads of posts here i can see that having a healthy liver again would be nice..i do know though that most folks that turn 50 notice slowing down and things happening even if they don't have hep...i'm 55 and i think my anxiety has a lot to do with my sx...so as i look ahead one of my major goals in the next couple years is to get my anxiety under control...billy

I assume that some of the "bioidentical hormone treatment" docs will, simultaneously to the testosterone patch/cream, actually prescribe a low dose/high potency aromatase inhibitor - like Arimidex- that will even by itself increase testosterone levels by blocking the neg feedback as mentioned above,( that results from the Estrogen conversion of natural or external testosterone).

In studies this low level aromatose inhibition in men with mildy hypogonadal levels has by itself, without external testosterone, raised the total and even more substantially the free testosterone levels by 50 to 100%.

not sure if i completely understand, are you saying that someone could take just the aromatase inhibitor to raise testosterone levels? and not a patch or cream that is more dangerous or body becomes dependent on? i was looking into this and from what i read it is prescribed mostly to women after breat cancer, etc. it is one thing to have this awful HCV disease but would be alot worse if i turned into a woman with it :-)

. It is the chemical androst-4-ene-3,6,17-trione, best to be described as a steroid derivative of estrogens ( additional "oxo"group in position 6), with exceptionally high binding affinity/or even covalent attachment to the Aromatase.

They call it a "suicide inhibitor" because once bound, it will not release the enzyme. Not necessarily a bad thing.
It has been tested eg in a trial in 16 eugonadal ( normal testosterone secretion/function) males and was effective in raising free testosterone by 90% and DHT by 200%. Thus far no neg effects on serum safety markers (like LFTs, lipid parameters) were observed.
Nobody knows if this would be safe long term and certainly nobody knows if it would additionally harm an HCV affected liver. 300mg is a high dose.

The approved aromatase inhibitors are typically to be used by women to reduce their circulating estogen levels in postmenopausal women in order to minimize their risk of reocurrence of breast cancer,

The use of these to increase male testosterone prduction by partial inhibition of the estrogen dependent feedback cycle to the hypothalamus has been tested experimentally, it does work in that it indeed increases total and free testosterone levels with no external testosterone provided, but it has not been approved for this reason, nor has its safety been tested. The main side effect to be expected is a reduction in male estrogens as well. I was basically referring to the fact that some practitioners(doctors) of male HRT probably use it off label for this purpose already.

I just went 48 weeks on interferon and Riba 1200 aday. I was tested and had no detectable virus. Now it has been 6 mos and it is back at 600,000. They are telling me that is low. What I am getting at is I was a bodybuilder and took Testosterone in large doses. Just makes me wonder if we are being left out of some important information. The Doc told me I could go back on again but for a longer duration but I really don't think I can do it again or maybe I could with some Testosterone.

The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.